Medicaid Waiver Services Denied At Random, Suit Alleges

Numerous individuals with disabilities are being denied the opportunity to apply for Medicaid waiver services in Pennsylvania, according to a federal lawsuit.

After participating in brief telephone interviews, people with disabilities are being told they are not eligible for the Medicaid program, according to a suit filed Monday by the Disability Rights Network of Pennsylvania. What’s more, individuals are not offered any information on how to appeal the decision.

However, when the same individuals call with the assistance of an advocate, they are often allowed to apply to the program which provides in-home care services.

That’s what happened to Tracey Melia, 50, who has cerebral palsy. She was told over the phone that she did not qualify for waiver services even though she needs personal care and housekeeping assistance. But when Melia called again with the help of her local United Cerebral Palsy chapter, she was given an opportunity to apply.

Melia is one of six individuals with disabilities who are named as plaintiffs in the lawsuit. Attorneys for the group are seeking class action status for the case, arguing that hundreds, if not thousands, of residents have been affected.

Even in situations where people are allowed to apply, the suit alleges that eligibility decisions are often not reached within the required 90-day period.

“It is unconscionable that people in dire need of services must wait for many months just to have their applications processed,” says Robert Meek, an attorney at the Disability Rights Network of Pennsylvania who’s representing the group. “These are people who cannot wait.”

The lawsuit names Pennsylvania’s acting secretary of public welfare, Gary Alexander, and asks the court to force changes such that Medicaid waiver applications are considered in a fair and timely manner.

Calls to the state’s Department of Public Welfare seeking comment were not returned.

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